Hirlinger W K, Pfenninger E
Anaesthesist. 1987 Mar;36(3):140-2.
Twenty traumatized patients suffering from fractures and soft tissue injury were given either 0.25 mg/kg or 0.5 mg/kg ketamine intravenously for analgesia. Within 5 min effective analgesia was present in both groups and lasted for 10-15 min. The higher dose of ketamine led to an impairment in the level of consciousness. These findings were in agreement with plasma levels of ketamine: in the 0.25 mg/kg group the plasma levels (median) were 167 ng/ml after 5 min, 92 ng/ml after 10 min, 82,5 ng/ml after 15 min, and 46 ng/ml after 30 min (n = 4). In the 0.5 mg/kg group the plasma levels (median) were 238 ng/ml after 5 min, 189 ng/ml after 10 min, 135 ng/ml after 15 min, and 118 ng/ml after 30 min. Considering the influence on consciousness, we recommend the administration of 0.25 mg/kg ketamine intravenously for analgesia in traumatized patients without head injury. It may be necessary to repeat the same dose if pain re appears.
20名患有骨折和软组织损伤的创伤患者静脉注射0.25mg/kg或0.5mg/kg氯胺酮用于镇痛。两组患者在5分钟内均出现有效镇痛,且持续10 - 15分钟。较高剂量的氯胺酮导致意识水平受损。这些发现与氯胺酮的血浆水平一致:在0.25mg/kg组中,5分钟后血浆水平(中位数)为167ng/ml,10分钟后为92ng/ml,15分钟后为82.5ng/ml,30分钟后为46ng/ml(n = 4)。在0.5mg/kg组中,5分钟后血浆水平(中位数)为238ng/ml,10分钟后为189ng/ml,15分钟后为135ng/ml,30分钟后为118ng/ml。考虑到对意识的影响,我们建议在无头部损伤的创伤患者中静脉注射0.25mg/kg氯胺酮用于镇痛。如果疼痛再次出现,可能需要重复相同剂量。